Heart Attack Archive

So why don't more take advantage of it after a heart attack?

Cardiac rehabilitation is recommended for both men and women after a heart attack or coronary artery bypass surgery, Through a structured, multi-week program that promotes supervised exercise, proper medication use, and a healthy lifestyle, the cardiovascular system recovers and stamina returns. People feel better, are able to do more, and are less likely to become bedridden or to die from heart disease.

Contrast-enhanced computed coronary tomographic angiography (CCTA), a noninvasive technology, accurately diagnosed or ruled out heart attack much faster than standard evaluation methods.

Heart attack survivors are at high risk for another heart attack or stroke, but until recently, no one knew why. Now an international study led by Harvard physicians and published online in Nature has found that heart attack triggers an immune response that accelerates the development of atherosclerosis and inflammation in cholesterol-filled plaques embedded in artery walls. "It's an ancient ‘fight-or-flight' response to injury, but instead of healing the wound, it accelerates the underlying disease," says senior author Dr. Matthias Nahrendorf of the Center for Systems Biology at Massachusetts General Hospital (MGH) and an assistant professor of radiology at Harvard Medical School.

During a heart attack, sympathetic nervous system activation causes stem cells to be released from the bone marrow. Stem cells induce production of monocytes and other immune cells in the spleen. These cells accumulate at yet-unruptured plaques, aggravating existing inflammation and triggering the release of enzymes that may cause those plaques to rupture.

Q. I am 90 years old and have had severe heart failure for seven years after having a heart attack. I have an implantable defibrillator. It has never gone off. It is near the end of its lifetime, and the cardiologist asked me if I want it replaced. What would you advise?

A. Many people with severely damaged hearts receive implantable cardioverter-defibrillators (ICDs) because they have a high risk of sudden death from rhythm abnormalities. Fortunately, you have not had this problem, but you remain at considerable risk. If a dangerous arrhythmia occurs, the defibrillator might save your life.

A new report answers the questions on everyone's mind.

After a heart attack or revascularization procedure, many people wonder whether it will be safe to resume sexual activity, and if so, when. They may worry about having another heart attack, or about dying during intercourse. If they have had bypass surgery, they may worry that sexual activity might be painful. Despite the importance of sex in a healthy relationship, many people (including doctors) are uncomfortable discussing it. As a result, questions go unasked, and information is not volunteered. The whole issue becomes the elephant in the room.

An aspirin a day has been shown to lower the risk of a first heart attack in men and a first stroke in women, but it also increases the risk of major bleeding in the digestive tract or brain.

The antibiotic azithromycin sometimes can trigger abnormal heart rhythms. Though uncommon, it is more likely to happen to people with heart failure, diabetes, or a previous heart attack.

Taking calcium supplements in an effort to strengthen bones may not be good for the heart. It's best to get calcium from dietary sources such as milk, yogurt, tofu, and spinach.

Biomarkers help individualize care for heart attack and heart failure.

If you have a heart attack or suffer from a heart condition, you can expect to be treated according to protocols that have proved effective in large groups of people. But individual variations in symptoms and responses to treatment are common.

Two simple steps will improve your odds.

If you have a heart attack and are treated with emergency angioplasty and stent placement, you may be discharged from the hospital in three days … and there's a one in 10 chance you will be readmitted within the month. The risk is even higher for those with multiple clogged arteries. These individuals also tend to have additional medical conditions and take more medications, all of which increase the risk of post–heart attack complications.

A study in the Journal of the American Medical Association examined the outcomes of 5,571 heart-attack survivors who were treated with angioplasty and discharged home in a few days. Those who were readmitted within 30 days tended to have coexisting medical problems, such as hypertension, atrial fibrillation, heart failure, chronic inflammation, pulmonary disease, diabetes, or atherosclerosis in more than one coronary artery.